Floor Statements

Mr. President, Nobel Peace Prize laureate Aung San Suu Kyi turns 64 today. Unfortunately, she will spend her birthday not in the company of family and friends but in Burma's notorious Insein Prison where 31 political prisoners have died since 1988.

Despite her apparently poor health, Suu Kyi is being housed in Insein because she is standing trial for the dubious charge of permitting a misguided American to enter her home. Sadly, Suu Kyi has already spent 13 of her last 19 birthdays under house arrest, and if convicted of these trumped-up charges by the Burmese regime, she could spend the next 5 birthdays in this foul prison.

The best gift Suu Kyi can receive for her birthday is for the regime to display some uncommon good sense and free her and other Burmese prisoners of conscience. My colleagues and I are committed to standing with her and the people of Burma for as long as it takes for that to occur.

I suggest the absence of a quorum.

Madam President, I ask unanimous consent that the order for the quorum call be rescinded.

Madam President, Americans certainly want health care reform. There is no dispute about that. People are frustrated with the high cost of care, and many are worried about losing the health care coverage they already have. Some can't afford care or have to choose between basic necessities and the treatments they need. These are some of the things that are wrong with the current system, and they need to be fixed.

But while all of us recognize that serious reform is needed, we should also recognize the necessity of getting it right. Before we rush to pass just anything in the name of reform, such as the bill introduced in the HELP Committee this week, Americans have a right to ask some very basic questions: How much will it cost? How will we pay for it? What will this mean for me and for my family?

As to the first question, Americans have good reason to be concerned about what the bill would cost. The Congressional Budget Office estimates that just a portion--just a portion--of the HELP Committee bill would spend $1.3 trillion over 10 years. That doesn't even include major portions of the final proposal, including a massive expansion of Medicaid, which will cost untold billions of dollars. These are staggering amounts of money for taxpayers to contemplate, which is why it

is troubling to a lot of people when we see committee members in such a rush to pass this legislation before the Congressional Budget Office even has a chance to fully estimate its cost. On something as important to the American people as health care reform, cost and effectiveness should be a higher priority than speed.

But even if we decided this bill was the right reform, another question arises: How would we pay for it? Most people don't walk onto a car lot, pick out the most expensive model, buy it, and then figure out how they are going to pay for it. Even if they wanted to, the car salesman wouldn't let them. We need to take the same approach here.

The proposal we have seen is full of creative new ways to spend taxpayer dollars, but it offers little in the way of offsetting the cost of the overall bill. We will have to either charge the money to the national credit card or, more likely, raise taxes on working families--in other words, more spending, higher taxes, and even more debt. So far, some of the taxes under discussion include a tax on soft drinks and juice boxes, the creation of a new tax on jobs, and new limits on charitable donations. But this would just be the beginning. The HELP Committee bill would be hugely expensive by any reckoning, and no one has a plan to pay for it. This isn't a very good start as far as health reform is concerned.

Americans are also right to wonder how these changes would affect the family budget. Will the HELP Committee's so-called reforms raise the health insurance costs for millions of families and businesses at a time when they are already struggling? This isn't a scare tactic or a theoretical question. Not only does the CBO estimate suggest the final bill is far too expensive, but we also have the example of States that have tried some of the proposals it suggests. Shouldn't we look at the experience of these States to determine whether we want to replicate these proposals nationwide?

Take Kentucky, for example. Many of the same concepts embraced by the HELP Committee bill were tried 15 years ago in my State--with disastrous results. Instead of reforms that were promised, Kentuckians were left with higher expenses and fewer choices for health coverage. Instead of more affordable care, one report estimates that 850,000 Kentuckians faced dramatically higher premiums. Instead of increased competition, about 50 insurance companies stopped offering individual insurance, leaving only a handful of private insurers and a government- run plan that wasn't affordable for taxpayers. After years of failure, many of these so-called reforms were repealed but not without significant damage to the Commonwealth. While the market has rebounded some, Kentucky's small businesses and families tell me that a lack of competition in the health care market continues to keep prices high. Shouldn't this experience figure into our consideration?

When it comes to our approach on legislation as costly as health care, we should learn from our experience with the stimulus. Democrats rushed that bill on the grounds that we needed it to jump-start the ailing economy. Yet a few months later we are already hearing outrageous stories of abuse and the unemployment rate actually continues to rise.

When it comes to specific proposals within any so-called health care reform bill, we should learn from the experience of Kentucky. We should not be rushed into enacting so-called reforms that cost taxpayers trillions and could increase premiums to consumers.

Americans indeed want reform, but they want us to do it right. They do not want a blind rush to spend trillions of dollars they and their grandchildren will have to pay for through higher taxes and even more debt.

Madam President, I yield the floor.

Mr. President, as the Senate takes up legislation today on emergency funding for combat operations in Iraq and Afghanistan, U.S. forces overseas can be reassured by this: unlike some of our previous recent debates, broad bipartisan agreement now exists in support of the proposition that the efforts of our service men and women should be funded and supported.

The supplemental agreement we are considering today includes nearly $80 billion for the Defense Department.

This funding will allow General Odierno and our uniformed men and women in Iraq to preserve the security gains they achieved during the surge, continue the transition to greater Iraqi control and capability, and deny refuge to al-Qaida in Iraq.

These funds will also be used to support a surge of forces in Afghanistan. And to those of us who ignored previous calls for arbitrary withdrawal dates in Iraq, it is particularly encouraging to see that President Obama has accepted the recommendations of General Petraeus for sending additional forces into Afghanistan. Success there isn't assured. Looking ahead, we can expect continued challenges associated with the upcoming Afghan national elections, the need to continue the expansion of the Afghan National Army and Police, and the need to combat corruption within the Afghan ministries. But the President was right to direct a surge of forces, appoint a new commander, and refocus our efforts on a broad counterinsurgency strategy to combat the Taliban.

Republicans support this surge and understand that broad security gains in Afghanistan cannot be achieved without the sustained improvement of the Afghanistan National Army and police forces. But this strategy will also require a sustained effort on the part of the government, the people, and the military forces of Pakistan to deny the Taliban, al-Qaida, and associated groups sanctuary in the tribal areas of Pakistan.

Just 2 months ago, the situation in Pakistan appeared to be so dire that the Secretary of State openly voiced concern that ``the Pakistani government is basically abdicating to the Taliban and to extremists.'' Since that time, the Pakistani military has moved in force into the Swat Valley to combat this threat. Our commitment to helping Pakistan prevail in this fight, which must be conducted as a counterinsurgency if it is to succeed, must be sustained. Fortunately, the supplemental contains funds to allow it.

Another important issue that must be addressed is the effort by some to force the release of photos depicting the alleged mistreatment or mistreatment of detainees in Iraq and Afghanistan. I am afraid that those encouraging the release of these photos fail to appreciate the potential consequences of such a release. The United States has painfully come to learn that al-Qaida and the Taliban are sophisticated communicators who exploit the airwaves and the internet. That is why the concerns expressed by our military commanders over the release of additional photos depicting the alleged mistreatment of detainees were of equal concern to our allies and friends. Iraq, Afghanistan, Pakistan, Egypt, Jordan, Saudi Arabia, and other countries deal each day with the threat of militant radicals. They know how these images can be exploited by terrorist groups, and the bitter consequences that could follow. Senators Lieberman, Graham, and McCain should be commended for making these concerns their own and carrying them to the American people.

Senator Graham noted on the floor yesterday that he believes the President shares the Senate's concerns about the potential dangers of releasing these photos. Last evening we passed legislation that would prevent any additional strategic harm from the release of photographs like these. Now the House must act.

Although Republicans support the President's support in the supplemental for our operations and overall objectives in Iraq and Afghanistan, a bipartisan majority disagree with the President in one important respect--and that is the administration's request for $80 million from Congress for the purpose of closing the detention facility at Guantanamo Bay before the administration even has a place to put the detainees who are housed there, any plan for military commissions, or any articulated plan for indefinite detention or for transferring detainees in a manner that ensures the safety of the American people.

During January of this year, by Executive order, the President established an arbitrary date for closing the detention facility at Guantanamo Bay. In April, the administration submitted its funding request to close Guantanamo as part of this supplemental bill, and the Senate voted 90-6 against including that funding. But it is worth reminding the Senate that the defense budget request for fiscal year 2010 includes a similar funding request, so the Senate will consider this matter again in the near future.

Bipartisan majorities of both Houses and the American people oppose closing Guantanamo without a plan, and several important questions remain unanswered: why was it necessary to bring detainees to the United States for prosecution, rather than using the courtroom at Guantanamo? If these terrorists are found to be not guilty by a civilian court, will they be returned to detention or released? What threat assessments were conducted prior to the recent transfers of detainees to Iraq, Chad, and Saudi Arabia?

The task force established by the President to review the closure of Guantanamo is scheduled to conclude its work in July, so Congress may learn of the administration's plans later this year. But this conference report requires the President to report to the Congress concerning the threat any further detainees who are released or transferred pose to the American people and our service members overseas. This will be of increasing importance as the task force decides the fate of detainees from Yemen.

As I said, Republicans supported the President when he reconsidered his plan to withdraw forces from Iraq. It is our hope that he will show similar openness when it comes to his arbitrary deadline for closing Guantanamo. The Senate has spoken clearly on this issue repeatedly. It is our hope that the administration heeds the wishes of the American people as expressed through their elected representatives when it comes to releasing and transferring dangerous terrorists.

As the arbitrary closure date approaches, we will continue to press this issue forward.

The wars in Iraq and Afghanistan have placed a great strain on our combat forces, the weapons and equipment that they need to succeed and on the training base that helps to keep the force ready. This bill continues the Senate's support for this force, and for the dangerous missions that they undertake on our behalf, and therefore it deserves our support. It is not perfect, but it meets the needs of our commanders in the field. America remains a nation at war. Our forces fighting these wars deserve our support, and the funding in this bill.

Mr. President, I rise today to introduce the Veterans Health Care Improvement Act of 2009.

As we all know, the Department of Veterans Affairs strives to provide the best possible health care for our nation's heroes. However, it has come to my attention that the quality of care provided to our nation's veterans has been inconsistent among community-based outpatient clinics. Some of these clinics, including two in my home state of Kentucky, are operated by private health care providers under VA contracts. These VA-contracted health care providers are compensated for their work at community-based outpatient clinics on a capitated basis, which means they are essentially paid based on how many new veterans they see during a pay period. These firms are therefore rewarded for the number of veterans they sign up, not for the quality of treatment provided to our veterans. I am concerned this provides contractors with the wrong incentives. Contracted health care providers should have the incentive to provide the best possible care for veterans, not simply get as many veterans as possible through the door once.

As a result of the capitated system, it has been reported that too many of our nation's heroes have faced difficulties at these clinics in scheduling appointments, have suffered from neglect or have received substandard health care. This occurred under the last administration and I am concerned it may be continuing in the current one.

As such, I am introducing the Veterans Health Care Improvement Act of 2009, which attempts to fix the way VA-contracted health care providers are compensated at clinics. This bill would require the VA to begin to introduce a pay-for-performance compensation plan for contractors, thereby gradually incentivizing a higher quality of care for veterans seen at privately-administered community-based outpatient clinics.

This bill gives the VA the flexibility to begin to implement such a system through a pilot program and leaves the VA the discretion as to how to adopt and best implement the pay-for-performance standards. In this respect, the bill defers to the VA on how to execute these changes. It is my hope that my colleagues will support this measure.

Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. President, I rise today to introduce the Veterans Health Care Improvement Act of 2009.

As we all know, the Department of Veterans Affairs strives to provide the best possible health care for our nation's heroes. However, it has come to my attention that the quality of care provided to our nation's veterans has been inconsistent among community-based outpatient clinics. Some of these clinics, including two in my home state of Kentucky, are operated by private health care providers under VA contracts. These VA-contracted health care providers are compensated for their work at community-based outpatient clinics on a capitated basis, which means they are essentially paid based on how many new veterans they see during a pay period. These firms are therefore rewarded for the number of veterans they sign up, not for the quality of treatment provided to our veterans. I am concerned this provides contractors with the wrong incentives. Contracted health care providers should have the incentive to provide the best possible care for veterans, not simply get as many veterans as possible through the door once.

As a result of the capitated system, it has been reported that too many of our nation's heroes have faced difficulties at these clinics in scheduling appointments, have suffered from neglect or have received substandard health care. This occurred under the last administration and I am concerned it may be continuing in the current one.

As such, I am introducing the Veterans Health Care Improvement Act of 2009, which attempts to fix the way VA-contracted health care providers are compensated at clinics. This bill would require the VA to begin to introduce a pay-for-performance compensation plan for contractors, thereby gradually incentivizing a higher quality of care for veterans seen at privately-administered community-based outpatient clinics.

This bill gives the VA the flexibility to begin to implement such a system through a pilot program and leaves the VA the discretion as to how to adopt and best implement the pay-for-performance standards. In this respect, the bill defers to the VA on how to execute these changes. It is my hope that my colleagues will support this measure.

Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. President, earlier this year, the new administration proposed and Democrats in Congress approved an economic stimulus bill that was meant to lift the economy at a time of massive job losses and widespread economic hardship. Not only was the bill enormously complex, it was also one of the costliest pieces of legislation ever proposed. Yet those who put it together insisted it be rushed to a vote.

Their reason, of course, was the economic downturn was too dire to wait. Trust us, they said; it is responsible, it is needed, and it will work. So this incredibly complex, enormously expensive bill, introduced on January 26, was passed less than 3 weeks later, just 24 hours--24 hours--after all its details

had been disclosed to the public for review.

At the time, I argued that spending this much borrowed money in the middle of a recession on a bill that had been rushed to the floor was extremely irresponsible. At a time when millions were struggling to make ends meet, Washington had no business borrowing hundreds of billions of dollars to pay for government golf carts and ATV trails in the name of economic stimulus. This week, Senator Coburn has catalogued some of the other outrages that are contained in this bill. Here are just a few:

The town of Union, NY, received a $578,000 grant that it didn't request for a homeless problem it claims it does not have. Florida is planning to spend $3.4 million in stimulus money to build a 13-foot turtle tunnel at Lake Jackson. That is more than a quarter of a million dollars per foot. This one takes the cake. In North Carolina, $40,234 in Federal stimulus money will pay for the salary--the salary--of someone whose job is to lobby for more stimulus money. That is $40,234 to pay someone to lobby for more stimulus money.

This would be comical if it weren't so maddening and if these projects hadn't been sold to the American people as the answer to our economic problems and if the administration hadn't assured us it would make sure every cent of this money was spent efficiently and without waste. But that was then.

The administration had promised since January it would keep an eye on how precious tax dollars were spent. But just months after the stimulus was signed into law, it was already admitting funds would be wasted and people were being scammed.

In January and February, administration economists took to the talk shows promising that the stimulus would create 3 to 4 million jobs. They said that if we passed the stimulus, the unemployment rate would now be about 8 percent. But just a few months later, with job losses continuing to mount, the administration admits their early predictions were simply a guess and that they guessed wrong. Today, the unemployment rate stands at 9.4 percent. Just yesterday, the administration said it expects unemployment to climb even higher.

The $1 trillion they said was absolutely necessary to jump-start the economy, and which was put on a fast track by an eager-to-please, Democratically led Congress, is now being called a very bad guess by the very people who proposed it.

Now they are asking us to do it again, only this time it is even more than $1 trillion, and the consequences could be far worse.

The early estimates we are getting for the health care proposal we have seen are that a portion of it--just a portion of it--will be $1.3 trillion. This figure, staggering in itself, doesn't even account for the money that would be needed to pay for expanding Medicaid and creating a new government-run plan. No one can tell us where any of this money will come from.

Yet similar to the stimulus, we are being told, in the most urgent tones, that this government takeover of health care is absolutely necessary, and we have to approve it as soon as possible, without review, without knowing the full cost, and without knowing how it will affect people's lives. Once again, it is rush and spend and rush and spend and a tidal wave of debt.

Everyone in America knows health care reform is needed in this country, but they want us to do it right. They do not want a blind rush to spend trillions--trillions--of dollars in the hope that the administration gets it right. During the debate over the stimulus, we were told we had to pass it right away, with just 24 hours to review-- or $42 billion an hour--for the sake of the economy. Now we are being told we need to approve a particular set of health care reforms for the sake of the economy, but we have no bill. We have no idea of its total cost. Yet it is rush, rush, rush.

We have heard all this before. We have made this mistake already. Americans will not be rushed into another one. Americans do want health care reform, but they want the right reform, not a government takeover disguised as a reform that takes away the care they have, replaces it with something worse, and costs untold trillions that they and their grandchildren will have to pay through higher taxes and even more debt.

The administration admits it made a mistake on its predictions about the stimulus. We shouldn't make the same mistake again when it comes to health care.

I yield the floor.

Mr. President, the health care system in this country is in urgent need of reform. People are frustrated with the soaring cost of care, and they are frustrated that so many of their fellow Americans lack the coverage they need that they should be able to expect in a nation as prosperous as ours. People are also worried about the enormous burden rising health care costs is placing on American businesses, which are being forced to put off pay increases and lay off workers to cope with rising insurance premiums. And now people are concerned that a new government health plan that is being talked about will make all of these problems even worse.

For weeks, many of us have been warning about plans for a government takeover of health care along the lines of takeovers we have seen in other areas of the private sector. Now the details of those plans are coming to light, and they raise two questions: How much is all this going to cost, and how are we going to pay for it?

Let's take just three proposals in the plan that is currently taking shape in the Health, Education, Labor, and Pensions Committee, the details of which are just beginning to emerge.

First, there is a massive expansion of Medicaid. Here is a program that was originally established as a partnership between the Federal Government and the States to assist the poor and disabled and which has become fiscally unsustainable. Yet, rather than reform this broken program, the HELP Committee is proposing a massive new expansion.

Second, the HELP Committee bill includes massive new subsidies for Americans with incomes higher than $100,000 a year. The purpose of these subsidies is to help defray the cost of rising insurance premiums. We all know health insurance is too expensive, but we ought to be working to lower those premiums, not opening the Federal checkbook to drive them up even higher.

Third, the HELP Committee bill establishes a new so-called prevention and public health investment fund. The details of this fund are a little murky, but early indications are that it will direct billions of dollars to things such as having the government build sidewalks and government-subsidized farmers markets. The idea here is to use tax dollars to encourage healthier lifestyles. But at a time when Americans are buried under medical bills and frightened about losing the coverage they have, farmers markets and sidewalks are not the reforms they have in mind.

Americans want serious health care reform, not expansion of programs that are already fiscally unsustainable, subsidies that disguise rising costs instead of addressing their causes, and billions for sidewalks and asparagus. These are precisely the kinds of proposals that mask the underlying problems and cause people to lose faith in government solutions, and they are simply not acceptable.

The details we are seeing from the HELP Committee should make us more skeptical of a government health plan, not less, and they should underscore for every American the need for the kinds of real, comprehensive reforms some of us have been calling for over the last few weeks.

The irony in this whole debate is that we are being told that America's fiscal future will be jeopardized if we do not allow these people who are proposing these outrageous so-called reforms to take over the entire health care system.

Preliminary estimates for this flawed legislative proposal are simply staggering. Just yesterday, the Congressional Budget Office released an estimate of just part--just part--of the HELP Committee bill. Focusing on just this one section, the CBO determined the bill will spend $1.3 trillion over 10 years, even though 37 million people would still be left without health insurance. Let me say that again, Mr. President. Just part of the HELP Committee bill would spend $1.3 trillion over 10 years, after which 37 million Americans would still be uninsured. Let me say that again, as I just have. One section of the bill--one section--$1.3 trillion, and 37 million still uninsured. And this isn't even a complete evaluation of the bill. Large proposals that will have a significant impact on the cost, such as the Medicaid expansion and a government-run plan, have not even been factored in yet.

Moreover, according to details of the HELP Committee plan, a new health care exchange would result in 15 million Americans losing the employer coverage they already have--further evidence if you like what you have, you may well lose it under a government-run plan.

How does the HELP Committee propose we pay for all this? Well, its proposal is full of creative new ways to spend taxpayer dollars, but it offers little in offsetting the cost of the overall bill. They will either charge the money to the national credit card or, more likely, raise taxes on working families. In other words, more spending, higher taxes, and even more debt. So far, some of the taxes under discussion include a new tax on soda, juice boxes, the creation of a new tax on jobs, and new limits on charitable deductions.

Based on the CBO estimate, these taxes would only be the beginning. The health care proposal being put together is not only extremely defective, it will cost a fortune. And that cost will come straight out of the taxpayers' pocketbook.

The bottom line is this: Under the illusion of reform, Americans will be asked to give up the care they like for something worse, and then they will be taxed to the hilt to pay for it. Americans don't want changes that make the entire health care system as unsustainable as Medicaid, and they don't want to go broke covering the cost.

Mr. President, I yield the floor.

Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. President, it was less than 3 weeks ago that the President announced his intentions to nominate Judge Sonia Sotomayor to the Supreme Court. In announcing her nomination, the White House made much of the fact that the judge had the

lengthiest judicial record in recent memory. Last week, in a departure from past practice, the Democratic leadership of the Judiciary Committee unilaterally scheduled her hearing without even notifying the ranking member. Because of this unwise and unfair approach, Judge Sotomayor's hearing will begin just 3 weeks from today. As I understand it, her questionnaire is still incomplete. Among other deficiencies, she has not provided materials from 17 cases she handled as a prosecutor, nor has she provided materials from any appellate cases she handled, and she has not provided materials from over 100 speeches she has given.

During the Roberts and Alito hearings, our Democratic friends repeatedly told us it was more important to do it right than to do it quick. Now that there is a Democratic President, it appears the attitude is to just do it. They want the shortest confirmation process in recent memory for a nominee with the longest judicial record in recent memory. There is clearly a double standard at play here--one that undermines our ability to fulfill one of the Senate's most important and solemn responsibilities.

Mr. President, as the national discussion over health care intensifies, one thing is already clear: Both Republicans and Democrats agree health care is in serious need of reform. The only thing that remains to be seen is what kind of reform we will deliver. Americans are increasingly worried about what they are hearing from Washington.

Americans want lower costs, and they want the freedom to choose their own doctors and their own care. What they do not want is a Washington takeover of health care along the lines of what we have already seen with banks, insurance companies, and the auto industry. Americans don't want a government-run system that puts bureaucrats between patients and doctors. They certainly don't want the kind of government boards that exist in places such as New Zealand and Great Britain that deny, delay, and ration treatments that are currently available to Americans.

Americans want change, but they do not want changes that will make existing programs worse. That is exactly what a government-run system would do.

Unfortunately, the notion of a government-run plan has been gaining steam. Over the past couple weeks, one Democratic leader after another has insisted that it be included as a part of any reform. The reaction to this should tell us something.

Among those who have begun to mobilize in opposition to America's plans are America's doctors who warn it would limit access to care and could lead to nearly 70 percent of Americans being kicked off the health plans they currently have.

The U.S. Chamber of Commerce, which represents about 3 million businesses in this country, has warned that the creation of a government plan would lead to a government-run health care system. The CEO of the renowned Mayo Clinic warned that some of the best providers could go out of business. The National Federation of Independent Businesses, one of the Nation's leading associations of small businesses, has also expressed its concerns about a government-run plan.

Americans don't want the kind of government-run system that some in Washington have proposed. They do not want politicians to use the real problems we have in our health care system as an excuse to tear down the whole thing, take away everything that is good about it, and replace it with something worse. They want practical solutions to specific problems, and that is what the rest of us are proposing.

Here are some commonsense proposals: We all agree health care in this country is too expensive. Americans don't think basic procedures should break the bank, and American families shouldn't have to worry about going bankrupt if a family member becomes ill.

But government-run health care will only make matters worse. If our experience with Medicare shows us anything, it is that the government health plans are not--I repeat are not--cost effective.

Over the weekend, the administration proposed making cuts to Medicare as a way of defraying the cost of a new government plan. That is exactly the wrong approach. America's seniors expect Congress to stabilize Medicare so it continues to serve their needs, not drain its resources to pay for another, even bigger government plan. Changes to Medicare should be used to make Medicare solvent for seniors today and for those who are paying into it and who will rely on the system tomorrow, not to build a brandnew government plan on top of one that is already on an unsustainable course. If we want to cut costs and rein in debt, then extending a Medicare-like system to everyone in America is exactly the wrong prescription. We need to make Medicare itself solvent and find ways to improve the current health care system.

One way to do that is to implement reforms that we know will save money. We could start with illness prevention programs that encourage people to quit smoking and to control their weight. It is no mystery that smoking and obesity are leading causes of the kinds of chronic diseases that are driving up health care costs. And finding ways to reduce these illnesses would also reduce costs. We should allow employers to create incentives for workers to adopt healthier lifestyles.

We should also encourage the same kind of robust competition in the health insurance market that has worked so well in the Medicare prescription drug benefit, Part D. We can enact long-overdue reforms to our Nation's medical liability laws. For too long, the threat of frivolous lawsuits has caused insurance premiums for doctors to skyrocket. Doctors then pass these higher costs on to patients, driving up the cost of care. Well, most people think health care dollars ought to be spent on health care, not insurance premiums. Yet doctors all across America are not only passing along the costs of higher and higher premiums, they are also ordering expensive and unnecessary tests and procedures to protect themselves against lawsuits.

One study suggests that roughly 9 out of 10 U.S. doctors in high-risk specialties practice some form of defensive medicine such as this--and the cost to patients is massive. Some doctors simply shut their practices or discontinue services as a result of these pressures. Patients such as Rashelle Perryman of Crittenden County Hospital are the ones who lose out. Rashelle's first two babies were born in Crittenden County Hospital, about 10 minutes from her home. But her third child had to be delivered about 40 miles away because rising malpractice rates caused doctors at Crittenden County Hospital to stop delivering babies altogether.

This isn't an isolated problem, and it is not just obstetricians. According to a report by the Kentucky Institute of Medicine, Kentucky is nearly 2,300 doctors short of the national average--a shortage that could be reduced, in part, by reforming medical malpractice laws.

Comprehensive health care reforms are long overdue--reforms that lower cost and increase access to care. But a government-run plan isn't the way to do it. There are other solutions that address our problems without undermining our strengths.

Over the past few weeks, I have warned about the dangers of government-run health care by pointing to the problems this kind of government-run system has created in places such as Britain, Canada, and New Zealand. These countries are living proof that when the government is in charge, health care is denied, delayed, and rationed. As I have noted, the main culprits in every case are the government boards that decide what procedures and medicines patients can and cannot have.

I have discussed how Britain's government board has denied care to cancer patients because the treatments were too expensive. In one case, bureaucrats in Britain refused to prescribe cancer drugs that were proven to extend the lives of patients because they cost too much. The government board explained it this way:

Although these treatments are clinically effective,

regrettably the cost . . . is such that they are not a cost

effective use of . . . resources.

I have also discussed how the government-run health care system in Canada

routinely delays care. Today, the average wait for a hip replacement at one hospital in Kingston, Ontario, is about 196 days. Knee replacement surgery at the same hospital takes an average of 340 days. The American people don't want to be told they have to wait 6 months for a hip replacement or a year for a knee replacement, but that is what could very well happen in a government-run health care system.

Finally, I have discussed how New Zealand's government board has rationed care by deciding which new hospital medicines are cost effective. In one case, government bureaucrats in that country denied patients access to a drug that was proven to be effective in fighting breast cancer because they thought it was too expensive. As one cancer doctor in the country put it:

New Zealand is a good tourist destination, but options for

cancer treatment are not so attractive there right now.

Americans want health care reform, but they don't want the kind of reform that denies, delays, and rations care, such as the government- run systems in New Zealand, Britain, and Canada. They don't want to be forced into a government plan that replaces the freedoms and choices they now enjoy with bureaucratic hassles, hours spent on hold, and politicians in Washington telling them how much care and what kind of care they can have. They want health care decisions left to doctors and patients, not remote bureaucrats. But if some in Washington get their way and enact a government takeover of health care, that is exactly what Americans can expect.

I suggest the absence of a quorum.

Madam President, the American people are frustrated with the U.S. health care system. But they are also increasingly concerned about some of the proposals coming from Washington. Now the alarms are beginning to sound. As reported in today's New York Times, the Nation's doctors are strongly opposed to the so-called government plan that appears to be gaining steam in Washington. The American Medical Association says the government plan threatens to restrict patient choice by putting out of business existing health plans that cover nearly 70 percent of Americans.

One estimate suggests that 119 million Americans could lose the private coverage they have as a consequence of the government plan. Moreover, the AMA, in its statement from yesterday, notes that ``the corresponding surge in public plan participation would likely lead to an explosion of costs that would need to be absorbed by taxpayers.''

Republicans and Democrats alike agree that health care reform is needed in this country. But a government plan is not the kind of reform the American people want. They want real reform for a system that's in serious need of it. Unfortunately, what some in Washington are proposing instead is the illusion of a reform that will replace what is good about health care in America with something that is far worse.

Instead of making health care more affordable and accessible, these proposals could make treatments and procedures that everyday Americans currently take for granted less accessible or even impossible to obtain--even as these proposals would add to the colossal and unsustainable debt that already burdens the Federal Government.

I have spoken repeatedly on the Senate floor about the dangers of a government-run health plan. By drawing on the experience of countries that have already adopted these government-run system I have pointed out the serious problems government-run health care creates for millions around the world. I have noted that a common defect of these government-run plans is that they deny, delay, and ration health care. And I have noted that the primary culprit in almost every case is the so-called government board that these countries have established to decide which treatments and medicines patients in these countries can and cannot have. This morning I would like to focus again on these so- called government boards, so people have an idea of what they could expect from a government-run plan here in the U.S.

Britain's government board, the National Institute for Health and Clinical Excellence, or NICE, is responsible for setting guidelines on the use of drugs and treatments for patients in that country. The government bureaucrats at this agency are supposed to weigh the effectiveness of a medicine or a treatment against its cost to the government. If the government thinks that a drug is too expensive, it can refuse to make it available to patients, regardless of any potential benefits.

Last summer, the board in Great Britain denied patients in that country access to four kidney cancer drugs that have the potential to extend life. Here's the chilling explanation it gave to justify the move.

Although these treatments are clinically effective,

regrettably the cost . . . is such that they are not a cost-

effective use of . . . resources.

After a public outcry, NICE reversed its position on one of the drugs but affirmed its ban on the other three.

In New Zealand, a government board known as Pharmac reviews potential drugs and treatments and decides whether they should be prescribed to

patients in that country. Pharmac says its goal is to use its ``expertise'' to ``help . . . decide which new hospital medicines are cost-effective.'' And like the government board in Great Britain, if Pharmac does not think a drug's cost justifies its benefits, it can refuse to make it available to patients or doctors who want it.

One drug that Pharmac did not think was worth the cost was Herceptin, which had proven to be effective in fighting breast cancer. Although Pharmac began covering the drug for advanced breast cancer in 2002, it refused to fund the drug for early stage breast cancer. After a public outcry and a reevaluation of the decision, Pharmac finally relented and decided to allow the drug for early stage breast cancer in 2007, but only for a limited amount of treatments.

These kinds of decisions about which drugs should or should not be covered are based on a method commonly known as ``comparative effectiveness.'' Comparative effectiveness is not alien to the U.S. health care system. Indeed, the stimulus bill Congress passed earlier this year included significant funding to lay the groundwork for just this kind of research in the United States. In my view, the more research we do on the effectiveness of drugs and treatments the better. Doctors should have as much good information as possible in dealing with their patients.

What Americans strenuously oppose, however, is the government using this information to deny access to treatment or procedures that patients and doctors choose to pursue--just as government agencies such as NICE and Pharmac do in Great Britain and New Zealand. Americans oppose this kind of government-mandated limitation on health care. They simply will not allow it.

That is why my friend, Senator Kyl, will propose a bill that will prohibit the government from ever using comparative effectiveness in this way. It is a wise bill, and it should be included as a part of any health reform we consider. Americans want their doctors to have clinical information on which treatments work best and which ones do not. But government bureaucrats should not be able to use that information to determine what treatments Americans can or cannot get. That is a decision we currently leave between a patient and his or her doctor, and that is where it should remain.

Americans want to see changes in the health care system, but they don't want changes that deny, delay, or ration care. They want reforms that control costs, even as they protect patients. They want us to discourage frivolous medical liability lawsuits that limit access to care in places such as rural Kentucky. They want prevention and wellness programs that cut costs by helping people quit smoking, overcome obesity, and diagnose illnesses early. And they want us to address the needs of small businesses without imposing new mandates or taxes that kill jobs.

All of us want reform, but the government-run plan some are proposing in the United States is not the kind of change Americans are looking for. We should learn the lessons from problems we have seen in countries such as Great Britain and New Zealand. We should learn a lesson from the nightmares so many people in these countries and their families have endured as a result of government-run health care and the bureaucratic government boards that almost always come with it.

Madam President, I am about to yield the floor, but before I do that, I see my friend from Arizona is on the floor. I want to express to him my gratitude for his leadership on this very important issue. The most important issue we will be dealing with this year is the question of whether the government should literally take over and run 16 percent of our economy. We have seen the government take over banks, insurance companies, and automobile companies. Now it appears as if there is an effort underway to take over health care as well.

I thank my friend from Arizona for the contribution he has made on this important issue in the past and say we are looking forward to working together on this in the future.

Madam President, I yield the floor.

Mr. President, Americans are increasingly frustrated with the U.S. health care system as we know it. They expect real reform, not just the promise of reform that never seems to come or the illusion of reform that ends up destroying what is good about the current system and replacing it with something that is actually worse.

Americans don't think basic medical procedures should break the bank, and they don't understand why millions of Americans have to go without basic care in a nation as prosperous as our own. Still, many Americans are quite happy with the health care they currently have, and they don't want to be forced into a government plan they don't like.

So the need for reform is not in question. The real question is what kind of reform--the kind that makes care more affordable and accessible or the kind that makes existing problems worse.

One thing most people like about health care in the U.S. is the quality of cancer care that's available here. Far too many Americans die from cancer. Yet for all the problems we have, the fact is, America boasts some of the highest cancer survival rates in the world. And that is not the kind of thing Americans want to see change. But it could very well change if the U.S. adopts a government-run health care system along the lines of the one some are proposing.

A recent study comparing U.S. cancer survival rates with other countries found that, on average, U.S. women have a 63 percent chance of living at least 5 years after a cancer diagnosis compared to a 54 percent rate for women in Britain. As for men, 66 percent of American males survive at least 5 years while 45 percent of British men do.

Just as important as treatment is early detection. And here again, the U.S. routinely out performs countries with government-run health care systems. According to one report, 84 percent of women between the ages of 50 and 64 get mammograms regularly in the United States--far higher than the 63 percent of women in the United Kingdom. Access to preventive care is extremely important and, frankly, when it comes to breast cancer, preventive care is something we do quite well in the

Mr. President, Senator Leahy's decision to rush Judge Sotomayor's confirmation hearing is, indeed, puzzling. It risks resulting in a less-informed hearing, and it breaks with years of tradition in which bipartisan agreements were reached and honored over the scheduling of hearings for Supreme Court nominees. It damages the cordiality and good will the Senate relies on to do its business. These kinds of partisan maneuvers have always come with consequences. This time is no different.

The explanations that some of our friends offered yesterday to justify a rushed hearing were almost as remarkable as the decision itself and the partisan way in which it was handled. Some said Republicans proposed unreasonable hearing dates. Yet no one can cite the time and place when any of these supposed requests were made.

But blaming Republicans for statements they never made was not as ludicrous as the claim that Judge Sotomayor's long judicial record is somehow reason to rush the review process. Not only is this counterintuitive--why should it take less time to read more cases?--it also flies in the face of every statement our Democratic friends made on the topic after the nomination of the last two Supreme Court nominees.

Time and time again, they told us the Senate was not a rubberstamp and that hearings for Judge Alito and Judge Roberts could not be rushed. As Senator Leahy put it at the time:

We want to do it right. We don't want to do it fast.

Republicans respected these requests because we recognized the importance of a thorough review. On the Alito nomination, for instance, Senators had 70 days to prepare for a hearing on a nominee who, as Senator Leahy noted at the time, had handled some 3,500 cases on the Federal bench. Judge Sotomayor has handled over 3,600 cases, so it stands to reason we would have as much time to review her record as we did Judge Alito's. But for some reason, the old standard has been thrown out as new reasons have emerged for rushing the process on this nominee.

As Senator Sessions informed us yesterday, the questionnaire Judge Sotomayor filled out suffers from significant omissions. For example, she failed to produce numerous opinions from cases in which she was involved as a district attorney.

In addition, she failed to produce a memorandum from her time with the Puerto Rican Legal Defense Fund that opposed the application of the death penalty. When this omission was brought to the judge's attention, I understand the White House then provided this memorandum, saying it was an oversight. But in the rush to complete the questionnaire in order to garner a talking point, you are prone to these sorts of mistakes. This, of course, counsels the Senate to have a thorough, deliberative process, not a rush to judgment in order to meet an arbitrary deadline.

When it came to Republican nominees such as Judge Roberts and Judge Alito, our Democratic friends wanted to review the record, and Republicans worked in a bipartisan fashion to come to a consensus on a fair process that respected the minority's rights. Yet when it comes to a Democratic nominee, our friends want to deny Republicans the same rights. They want the shortest confirmation timeline in recent memory for someone with the longest judicial record in recent memory. Let me say that again.

They want the shortest confirmation timeline in recent memory for someone with the longest judicial record in recent memory.

This violates basic standards of fairness, and it prevents Senators from carrying out one of their most solemn duties--a thorough review of the President's nominee to a lifetime position on the highest Court in the land. The decision to short circuit that process is regrettable and completely unnecessary.

I yield the floor.

Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. President, it wasn't that long ago that the Senate voted almost unanimously to oppose bringing any terrorists at Guantanamo to the United States. But earlier this week, the administration ignored the will of the American people as expressed through that Senate vote by transferring a Guantanamo detainee named Ahmed Ghailani to New York. The purpose of the transfer is to try Ghailani in a U.S. civilian court for his role in the African embassy bombings of 1998. The administration's decision raises a number of serious questions.

First, Ghailani has already admitted that he attended a terrorist training camp in Afghanistan and assisted those who planned and carried out the embassy attack, but says he did so unintentionally. In a U.S. civilian court, if you're found not guilty, you're allowed to go free. So if we are going to treat this terrorist detainee as a common civilian criminal, what will happen to Ghailani if he's found not guilty? And what will happen to other detainees the administration wants to try in civilian courts if they are found not guilty? Will they be released? If so, where? In New York? In American communities? Or will they be released overseas, where they could return to terror and target American soldiers or innocent civilians?

Second, if Ghailani isn't allowed to go free, will he be detained by the government? If so, where will he be detained? Would the administration detain him on U.S. soil, despite the objections of Congress and the American people?

Third, why does the administration think a civilian court is the appropriate place to try Ghailani? Congress enacted the military commissions process on a bipartisan basis as a way to bring terrorists to justice without disclosing information that could harm national security. Some have complained that the previous administration moved too slowly on military commissions, but a lot of that delay was due to the constant legal challenges that were leveled against the process, including by some in the current administration. In fact, Ghailani's case was already being handled by the military commissions process--to the point that a judge had established a trial schedule for him. I ask unanimous consent that the trial schedule be printed in the Record.

This schedule would be well underway if the administration had not suspended all military commission proceedings several months ago. Now we will have to start the process for Ghailani over again in civilian court.

The administration made the right decision by reconsidering its position on military commissions and deciding to resume their use. So why did the administration decide to stop the military commission proceedings against Ghailani that were being conducted in the modern, safe, and secure courtroom at Guantanamo and move him to the U.S. to try him in civilian court? Is it because the Administration doesn't think that by deliberately targeting innocent American civilians Ghailani violated the law of war? Does it think he should be treated as just another domestic civilian defendant?

Fourth, how will the administration ensure that trying Ghailani in a U.S. court doesn't damage our national security? As we've seen in the past, trying terrorists in the U.S. has made it harder for our national security professionals to protect the American people.

During a previous trial of suspects in the African embassy bombings, evidence showed that the National Security Agency had intercepted cell phone conservations between terrorists. According to press reports, this revelation caused terrorists to stop using cell phones to discuss sensitive operational details.

And during the trial of Ramzi Yousef, the mastermind of the 1993 World Trade Center attack, testimony given in a public courtroom tipped off terrorists that the U.S. was monitoring their communications. As a result, these terrorists shut down that communications link and any further intelligence we might have obtained was lost.

On the question of Guantanamo, it became increasingly clear over time that the administration announced its plan to close the facility before it actually had a plan. If the administration has a plan for holding Ghailani if he is found not guilty, then it needs to share that plan with the Congress. These kinds of questions are not insignificant. They involve the safety of the American people. And that is precisely why Congress demanded a plan before the administration started to move terrorists from Guantanamo. The American people don't want these terrorists in their communities or back on the battlefield. But that is exactly where Ghailani could end up if he is found not guilty in a civilian court. Before it transfers any more detainees from Guantanamo, the administration needs to present a plan that ensures its actions won't jeopardize the safety of the American people.

Finally, earlier today, the Senate majority whip came to the floor and claimed there is evidence that al-Qaida may be recruiting terrorists within Guantanamo. I am glad to see that the majority whip appears to be acknowledging the FBI Director's concerns that Guantanamo terrorists could radicalize the prison population if they were transferred into the United States. The fact that these terrorists might be able to recruit new members and conduct terrorist activities from behind bars is an important one. I also find it preposterous that the majority whip would assert that because I and others--including, by the way, members of his own conference--want to keep dangerous terrorist detainees away from American communities, we will enable terrorists to escape justice. Keeping these terrorists locked up at Guantanamo, and trying them using the military commissions process, is the best way to deliver justice while protecting the American people.

Mr. President, I yield the floor.

I have yielded the floor. The Senator can feel free to make a statement.